assembly Bill A2317

2017-2018 Legislative Session

Relates to prescription drug formulary changes during a contract year

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Sponsored By

Current Bill Status - Passed Assembly


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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Actions

view actions (21)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Apr 30, 2018 recommitted to insurance
returned to senate
repassed assembly
Apr 17, 2018 amended on third reading 2317c
Apr 17, 2018 vote reconsidered - restored to third reading
returned to assembly
recalled from senate
Feb 06, 2018 referred to insurance
delivered to senate
passed assembly
Jan 23, 2018 amended on third reading 2317b
Jan 03, 2018 ordered to third reading cal.171
returned to assembly
died in senate
Jun 20, 2017 referred to rules
delivered to senate
passed assembly
Jun 14, 2017 amended on third reading (t) 2317a
May 18, 2017 advanced to third reading cal.390
May 16, 2017 reported
Jan 17, 2017 referred to insurance

Co-Sponsors

Multi-Sponsors

A2317 - Details

Law Section:
Insurance Law
Laws Affected:
Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in 2015-2016 Legislative Session:
A7707A

A2317 - Summary

Prohibits a health care plan from making prescription drug formulary changes during a contract year.

A2317 - Bill Text download pdf

                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2317

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                            January 17, 2017
                               ___________

Introduced  by M. of A. PEOPLES-STOKES, HARRIS -- read once and referred
  to the Committee on Insurance

AN ACT to amend the insurance law,  in  relation  to  prescription  drug
  formulary changes during a contract year

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The insurance law is amended by adding a new  section  4909
to read as follows:
  S  4909.  PRESCRIPTION  DRUG FORMULARY CHANGES. (A) A HEALTH CARE PLAN
REQUIRED TO PROVIDE ESSENTIAL  HEALTH  BENEFITS  SHALL  NOT,  EXCEPT  AS
OTHERWISE   PROVIDED  IN  SUBSECTION  (B)  OF  THIS  SECTION,  REMOVE  A
PRESCRIPTION DRUG FROM A FORMULARY:
  (I) IF THE FORMULARY INCLUDES TWO OR MORE TIERS OF BENEFITS  PROVIDING
FOR  DIFFERENT  DEDUCTIBLES, COPAYMENTS OR COINSURANCE APPLICABLE TO THE
PRESCRIPTION DRUGS IN EACH TIER, MOVE A DRUG TO A  TIER  WITH  A  LARGER
DEDUCTIBLE, COPAYMENT OR COINSURANCE, OR
  (II)  ADD  UTILIZATION  MANAGEMENT  RESTRICTIONS  TO A FORMULARY DRUG,
UNLESS SUCH CHANGES OCCUR AT THE  TIME  OF  ENROLLMENT  OR  ISSUANCE  OF
COVERAGE.    SUCH PROHIBITION SHALL APPLY BEGINNING ON THE DATE ON WHICH
OPEN ENROLLMENT BEGINS FOR A PLAN YEAR AND THROUGH THE END OF  THE  PLAN
YEAR TO WHICH SUCH OPEN ENROLLMENT PERIOD APPLIES.
  (B)  (I) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO OR MORE
TIERS OF BENEFITS PROVIDING FOR  DIFFERENT  DEDUCTIBLES,  COPAYMENTS  OR
COINSURANCE  APPLICABLE  TO  PRESCRIPTION  DRUGS IN EACH TIER MAY MOVE A
PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCIBLE, COPAYMENT OR  COIN-
SURANCE  IF AN AB-RATED GENERIC DRUG FOR SUCH PRESCRIPTION DRUG IS ADDED
TO THE FORMULARY AT THE SAME TIME.
  (II) A HEALTH CARE PLAN MAY REMOVE A PRESCRIPTION DRUG FROM  A  FORMU-
LARY  IF  THE  FEDERAL FOOD AND DRUG ADMINISTRATION DETERMINES THAT SUCH
DRUG SHOULD BE REMOVED FROM THE MARKET.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05529-01-7

Co-Sponsors

view additional co-sponsors

Multi-Sponsors

A2317A - Details

Law Section:
Insurance Law
Laws Affected:
Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in 2015-2016 Legislative Session:
A7707A

A2317A - Summary

Prohibits a health care plan from making prescription drug formulary changes during a contract year.

A2317A - Bill Text download pdf

                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 2317--A
                                                        Cal. No. 390

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                            January 17, 2017
                               ___________

Introduced  by  M. of A. PEOPLES-STOKES, HARRIS, SKOUFIS, BARRETT, NIOU,
  ORTIZ -- Multi-Sponsored by -- M. of A. ENGLEBRIGHT -- read  once  and
  referred  to  the  Committee  on Insurance -- reported from committee,
  advanced to a third reading, amended and ordered reprinted,  retaining
  its place on the order of third reading

AN ACT to amend the insurance law and the public health law, in relation
  to prescription drug formulary changes during a contract year

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The insurance law is amended by adding a new  section  4909
to read as follows:
  S  4909.  PRESCRIPTION DRUG FORMULARY CHANGES. (A) EXCEPT AS OTHERWISE
PROVIDED IN SUBSECTION (C) OF THIS SECTION, A  HEALTH  CARE  PLAN  SHALL
NOT:
  (I)  REMOVE  A  PRESCRIPTION  DRUG  FROM  A FORMULARY IF THE FORMULARY
INCLUDES TWO OR MORE TIERS OF BENEFITS PROVIDING FOR  DIFFERENT  DEDUCT-
IBLES, COPAYMENTS OR COINSURANCE APPLICABLE TO THE PRESCRIPTION DRUGS IN
EACH  TIER, MOVE A DRUG TO A TIER WITH A LARGER DEDUCTIBLE, COPAYMENT OR
COINSURANCE; OR
  (II) ADD UTILIZATION MANAGEMENT  RESTRICTIONS  TO  A  FORMULARY  DRUG,
UNLESS  SUCH  CHANGES  OCCUR  AT  THE  TIME OF ENROLLMENT OR ISSUANCE OF
COVERAGE.
  (B) PROHIBITIONS PROVIDED IN SUBSECTION  (A)  OF  THIS  SECTION  SHALL
APPLY  BEGINNING  ON THE DATE ON WHICH OPEN ENROLLMENT BEGINS FOR A PLAN
YEAR AND THROUGH THE END OF THE PLAN YEAR TO WHICH SUCH OPEN  ENROLLMENT
PERIOD APPLIES.
  (C)  (I) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO OR MORE
TIERS OF BENEFITS PROVIDING FOR  DIFFERENT  DEDUCTIBLES,  COPAYMENTS  OR
COINSURANCE  APPLICABLE  TO  PRESCRIPTION  DRUGS IN EACH TIER MAY MOVE A
PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCIBLE, COPAYMENT OR  COIN-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05529-04-7

Co-Sponsors

view additional co-sponsors

Multi-Sponsors

A2317B - Details

Law Section:
Insurance Law
Laws Affected:
Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in 2015-2016 Legislative Session:
A7707A

A2317B - Summary

Prohibits a health care plan from making prescription drug formulary changes during a contract year.

A2317B - Bill Text download pdf

                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 2317--B
                                                        Cal. No. 171

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                            January 17, 2017
                               ___________

Introduced  by  M. of A. PEOPLES-STOKES, HARRIS, SKOUFIS, BARRETT, NIOU,
  ORTIZ, SEPULVEDA, GALEF, ABINANTI, LAVINE -- Multi-Sponsored by --  M.
  of  A.  ENGLEBRIGHT, HEVESI -- read once and referred to the Committee
  on Insurance -- reported from committee, advanced to a third  reading,
  amended  and  ordered  reprinted,  retaining its place on the order of
  third reading -- ordered to  a  third  reading,  amended  and  ordered
  reprinted, retaining its place on the order of third reading

AN ACT to amend the insurance law and the public health law, in relation
  to prescription drug formulary changes during a contract year

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The insurance law is amended by adding a new  section  4909
to read as follows:
  S  4909.  PRESCRIPTION DRUG FORMULARY CHANGES. (A) EXCEPT AS OTHERWISE
PROVIDED IN SUBSECTION (C) OF THIS SECTION, A  HEALTH  CARE  PLAN  SHALL
NOT:
  (I) REMOVE A PRESCRIPTION DRUG FROM A FORMULARY;
  (II)  MOVE  A  PRESCRIPTION  DRUG  TO A TIER WITH A LARGER DEDUCTIBLE,
COPAYMENT, OR COINSURANCE IF THE FORMULARY INCLUDES TWO OR MORE TIERS OF
BENEFITS PROVIDING FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR  COINSURANCE
APPLICABLE TO THE PRESCRIPTION DRUGS IN EACH TIER; OR
  (III)  ADD  UTILIZATION MANAGEMENT RESTRICTIONS TO A PRESCRIPTION DRUG
ON A FORMULARY, UNLESS SUCH CHANGES OCCUR AT THE TIME OF  ENROLLMENT  OR
ISSUANCE OF COVERAGE.
  (B)  PROHIBITIONS  PROVIDED  IN  SUBSECTION  (A) OF THIS SECTION SHALL
APPLY BEGINNING ON THE DATE ON WHICH OPEN ENROLLMENT BEGINS FOR  A  PLAN
YEAR  AND THROUGH THE END OF THE PLAN YEAR TO WHICH SUCH OPEN ENROLLMENT
PERIOD APPLIES.
  (C) (I) A HEALTH CARE PLAN WITH A FORMULARY THAT INCLUDES TWO OR  MORE
TIERS  OF  BENEFITS  PROVIDING  FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR
COINSURANCE APPLICABLE TO PRESCRIPTION DRUGS IN EACH  TIER  MAY  MOVE  A
PRESCRIPTION DRUG TO A TIER WITH A LARGER DEDUCTIBLE, COPAYMENT OR COIN-
SURANCE  IF AN AB-RATED GENERIC EQUIVALENT FOR SUCH PRESCRIPTION DRUG IS
ADDED TO THE FORMULARY AT THE SAME TIME.

Co-Sponsors

view additional co-sponsors

Multi-Sponsors

A2317C (ACTIVE) - Details

Law Section:
Insurance Law
Laws Affected:
Add §4909, Ins L; add §4909, Pub Health L
Versions Introduced in 2015-2016 Legislative Session:
A7707A

A2317C (ACTIVE) - Summary

Prohibits a health care plan from making prescription drug formulary changes during a contract year.

A2317C (ACTIVE) - Bill Text download pdf

                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 2317--C
                                                        Cal. No. 171

                       2017-2018 Regular Sessions

                          I N  A S S E M B L Y

                            January 17, 2017
                               ___________

Introduced  by  M.  of A. PEOPLES-STOKES, SKOUFIS, BARRETT, NIOU, ORTIZ,
  SEPULVEDA,  GALEF,  ABINANTI,  LAVINE,  COLTON,  JEAN-PIERRE,  TAYLOR,
  BYRNE,  WEPRIN  -- Multi-Sponsored by -- M. of A. ENGLEBRIGHT, HEVESI,
  RA -- read once and referred to the Committee on Insurance -- reported
  from committee, advanced to  a  third  reading,  amended  and  ordered
  reprinted,  retaining  its  place  on  the  order  of third reading --
  ordered to a third reading, amended and ordered  reprinted,  retaining
  its  place  on  the  order  of third reading -- passed by Assembly and
  delivered to the Senate, recalled from the Senate, vote  reconsidered,
  bill  amended,  ordered reprinted, retaining its place on the order of
  third reading

AN ACT to amend the insurance law and the public health law, in relation
  to prescription drug formulary changes during a contract year

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  The insurance law is amended by adding a new section 4909
to read as follows:
  S 4909. PRESCRIPTION DRUG FORMULARY CHANGES. (A) EXCEPT  AS  OTHERWISE
PROVIDED  IN  SUBSECTION  (C)  OF THIS SECTION, A HEALTH CARE PLAN SHALL
NOT:
  (I) REMOVE A PRESCRIPTION DRUG FROM A FORMULARY;
  (II) MOVE A PRESCRIPTION DRUG TO A  TIER  WITH  A  LARGER  DEDUCTIBLE,
COPAYMENT, OR COINSURANCE IF THE FORMULARY INCLUDES TWO OR MORE TIERS OF
BENEFITS  PROVIDING FOR DIFFERENT DEDUCTIBLES, COPAYMENTS OR COINSURANCE
APPLICABLE TO THE PRESCRIPTION DRUGS IN EACH TIER; OR
  (III) ADD UTILIZATION MANAGEMENT RESTRICTIONS TO A  PRESCRIPTION  DRUG
ON  A  FORMULARY, UNLESS SUCH CHANGES OCCUR AT THE TIME OF ENROLLMENT OR
ISSUANCE OF COVERAGE.
  (B) PROHIBITIONS PROVIDED IN SUBSECTION  (A)  OF  THIS  SECTION  SHALL
APPLY  BEGINNING  ON THE DATE ON WHICH OPEN ENROLLMENT BEGINS FOR A PLAN

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05529-11-8

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